1547P - D-dimer lacks value as a screening tool for venous thrombosis but exhibits prognostic power in advanced cancer patients

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Supportive Care
Presenter So Yeon Oh
Citation Annals of Oncology (2014) 25 (suppl_4): iv517-iv541. 10.1093/annonc/mdu356
Authors S.Y. Oh, S.J. Park, H.J. Jun, I.K. Park, G.J. Lim
  • Internal Medicine, Seoul Medical Center, 131795 - Seoul/KR

Abstract

Aim

The incidence of venous thromboembolism (VTE) in advanced cancer patients is high. Analysis of D-dimer concentration serves as a screening test for VTE due to its low cost and high sensitivity, although D-dimer is frequently elevated in response to other causes, such as infection or malignancy. This study aimed to evaluate the role of D-dimer in advanced cancer patients.

Methods

We retrospectively reviewed medical records of patients from July 2012 to October 2013. Incurable cancer patients exhibiting characteristics described in Well's prediction model underwent a D-dimer test at admission.

Results

Among 343 incurable cancer patients, 142 patients received a Well's score ≥2 at admission. Only 4 patients (2.8%) had normal D-dimer levels (<0.5 &mgr;g/mL), and the majority (n = 115, 81.0%) exhibited levels >2.0 &mgr;g/mL. Radiologic workups were performed for 20 patients, because VTE diagnosis would not be beneficial to patients facing imminent death. These workups confirmed VTE in 8 patients (40%). The survival time was significantly differed according to D-dimer levels with a median of 48 days (95% CI, 25.9-70.1) when D-dimer levels were <2 &mgr;g/mL and 19 days (95% CI, 13.7-24.3) days when D-dimer levels were higher (Log-rank, p < 0.001). D-dimer levels were negatively correlated with survival according to Spearman's rank correlation analysis (coefficient -0.335, p < 0.001).

Conclusions

In advanced cancer patients, D-dimer concentrations may lack VTE screening power as patients without VTE also exhibited high levels of D-dimer; however, these values did exhibit prognostic power in these patients.

Disclosure

All authors have declared no conflicts of interest.